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ICD-10 Guide
ICD-10 CodesC34.01

C34.01

Billable

Malignant neoplasm of right main bronchus

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 C34.01 is a billable code used to indicate a diagnosis of malignant neoplasm of right main bronchus.

Key Diagnostic Point:

C34.01 refers to a malignant neoplasm located in the right main bronchus, which is a critical airway structure leading to the right lung. This type of lung cancer is often associated with significant morbidity and mortality, primarily due to its aggressive nature and late presentation. Risk factors include a history of smoking, exposure to environmental pollutants, and genetic predispositions. Symptoms may include persistent cough, hemoptysis, chest pain, and dyspnea. Diagnosis typically involves imaging studies such as chest X-rays and CT scans, followed by bronchoscopy for biopsy confirmation. Staging is crucial for determining the extent of disease and guiding treatment, which may include surgical resection, chemotherapy, and radiation therapy. Molecular markers, such as EGFR mutations and ALK rearrangements, play a vital role in personalized treatment approaches, particularly in non-small cell lung cancer (NSCLC) cases. Understanding the nuances of this diagnosis is essential for accurate coding and optimal patient management.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiation between types of lung cancer (e.g., small cell vs. non-small cell)
  • Staging complexity and its impact on treatment options
  • Need for precise documentation of smoking history and environmental exposures
  • Involvement of multiple specialties in management (oncology, pulmonology, surgery)

Audit Risk Factors

  • Inadequate documentation of smoking history
  • Failure to document staging details
  • Lack of clarity in treatment plans
  • Misclassification of the type of lung cancer

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed treatment plans, staging information, and molecular testing results.

Common Clinical Scenarios

Management of newly diagnosed lung cancer patients, follow-up for treatment response.

Billing Considerations

Ensure accurate coding of treatment modalities and staging.

Pulmonology

Documentation Requirements

Pulmonary function tests, imaging studies, and symptom assessments.

Common Clinical Scenarios

Evaluation of patients with respiratory symptoms and suspected lung cancer.

Billing Considerations

Documenting the patient's smoking history and environmental exposures is critical.

Coding Guidelines

Inclusion Criteria

Use C34.01 When
  • Follow the official ICD
  • CM guidelines for coding neoplasms, including the need for specificity in the location and type of cancer

Exclusion Criteria

Do NOT use C34.01 When
  • Ensure compliance with the inclusion and exclusion criteria for lung cancer codes

Related ICD-10 Codes

Related CPT Codes

31622CPT Code

Bronchoscopy, rigid or flexible

Clinical Scenario

Used for biopsy confirmation in suspected lung cancer cases.

Documentation Requirements

Document indication for bronchoscopy and findings.

Specialty Considerations

Pulmonology specialists should ensure accurate reporting of findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding lung cancers, including anatomical locations and staging, which enhances data accuracy and improves patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding lung cancers, including anatomical locations and staging, which enhances data accuracy and improves patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding lung cancers, including anatomical locations and staging, which enhances data accuracy and improves patient management.

Resources

Clinical References

  • •
    American Cancer Society - Lung Cancer

Coding & Billing References

  • •
    American Cancer Society - Lung Cancer

Frequently Asked Questions

What is the significance of staging in lung cancer coding?

Staging is crucial as it determines treatment options and prognosis. Accurate staging documentation is essential for proper coding and reimbursement.